Shaeer's Corporal Rotation III: Shortening-Free Correction of Congenital Penile Curvature-The Noncorporotomy Technique.

BACKGROUND

Shortening-free correction of congenital ventral penile curvature by rotation of the corpora cavernosa was first introduced in 2006 (Shaeer's corporal rotation I). The basic principle was shifting the concavity of both corpora cavernosa from the ventral aspect of the penis to the lateral aspects, in opposition. Rotation was achieved by approximating short parallel incisions on the dorsum of both corpora cavernosa. In 2008, we reported modification of the technique (Shaeer's corporal rotation II), in which the incisions spanned the whole length of the corpora cavernosa.

OBJECTIVE

The current modification, Shaeer's corporal rotation III (the noncorporotomy technique) simplifies corporal rotation further and addresses shortcomings.

DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective study of 127 cases of congenital ventral penile curvature 25-90° operated at Kamal Shaeer Hospital, Cairo, Egypt, from 2009 to 2015.

SURGICAL PROCEDURE

The neurovascular bundle was mobilized, and the corpora were rotated by approximating premarked respective points on either side of the deep dorsal vein using polyester sutures without incising the tunica albuginea.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Intraoperative postrotation angle and erect length and girth.

RESULTS AND LIMITATIONS

On-table measurements showed a mean prerotation erection angle of 66.5° ± 17.9° (range: 25-90°; median 65°). Following rotation, the angle was 0.47° ± 1.8° (p<0.001) and length was 0.06 ± 0.25 cm longer (p=0.007), whereas girth was 0.77 ± 0.9 cm narrower (p<0.001). Complications included 11 cases (8.7%) of ventral wound gaping and 3 (2.4%) with mild recurrence not requiring correction. The International Index of Erectile Function was 24.99 ± 0.9, with an increase of 13.35 ± 3.4 over the preoperative state (p<0.001).

CONCLUSIONS

Shaeer's corporal rotation III enables correction of any degree of ventral congenital penile curvature, with neither shortening nor erectile dysfunction.

PATIENT SUMMARY

Shaeer's corporal rotation is a surgical technique for correction of severe degrees of innate downward curvature of the penis, without shortening.